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General NPI Number Information
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NPI Number | 1992000152
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Entity Type | Organization
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Legal Business Name | ONG RUBIN SHAHMIR A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 1411 OLIVER RD STE 250
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City | FAIRFIELD
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State | CA
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Zip | 94534-3425
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Country | US
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Telephone | 707-446-4379
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Fax | 707-446-4417
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Provider Business Mailing Address
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Address Line | 1411 OLIVER RD STE 250
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City | FAIRFIELD
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State | CA
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Zip | 94534-3425
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Country | US
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Telephone | 707-446-4379
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Fax | 707-446-4417
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Authorized Official
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Title or Position | PARTNER/PRACTICE PHYSICIAN
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Name | EHSAN SHAHMIR
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Credential | MD
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Telephone | 707-446-4379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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